<?=$this->load->view('include_header',null)?>
	<div id="top-panel">
		<div id="panel">
			<ul>
				<li class="current"><a href="<?=site_url('archive/idcard/'.$id)?>" class="report"><?=(empty($id))?"录入新":"编辑"?>客户基本信息</a></li>
				<?php if(!empty($info->id)):?><li><a id="printInfo" class="folder_table">打印本页信息</a></li><?php endif;?>
			</ul>
		</div>
	</div>
	<div id="wrapper">
		<div id="content">
			<div id="box">
<!-- table begin -->
<form method="post" id="form"  enctype="multipart/form-data" action="<?=site_url('schengen/nz_student_update/'.$cateid)?>">

	<h3>新西兰学生签证申请表[INZ 1012]</h3>
    <table width="100%">
    <thead>
        <tr>
          <td colspan="4" align="right"><img src="<?= (@$info->avatar)?@$info->avatar:'images/avatar.gif'?>" width="150" height="150" /></td>
		  <td align="right">
		  上传照片<br />
		  <input type="file" name="userphoto" /><br />
		  (.gif|.jpg|.png文件,最大1M)<br />
		  <?php if (@$info->attachment):?><a href="<?= @$info->attachment?>" target="_blank">点击下载附件</a><?php endif; ?>
		  &nbsp;&nbsp;&nbsp;&nbsp;上传附件<br />
		  <input type="file" name="userfile" /><br />
		  (.pdf|.zip|.rar|.doc,最大2M)		  </td>
        </tr>
    </thead>
    <tfoot>
        <tr>
            <td colspan="5" align="right">			
			<input type="hidden" name="id" value="<?=$id?>" />
			<input id="button1" type="submit" value="提交信息" />
			<input id="button2" type="reset" value="重置" />			</td>
        </tr>
    </tfoot>

    <tbody>
        <tr class="odd">
            <td colspan="5"><strong>Section A – Personal details</strong></td>
        </tr>
        <tr class="even">
            <td>A1. Name as shown in passport</td>
			<td colspan="4">Family/last name 
			  <input type="text" name="surname" value="<?= @$info->surname?>" />			  
			  &nbsp;&nbsp; Given/first name(s) 
		      <input type="text" name="firstname" value="<?= @$info->firstname?>" /></td>
        </tr>
        <tr class="odd">
            <td>A2. Preferred title</td>
            <td colspan="4">
			<input type="radio" name="title" value="1" <?= (@$info->title==1)?'checked':''?> />Mr 
			<input type="radio" name="title" value="2" <?= (@$info->title==2)?'checked':''?> />Mrs 
			<input type="radio" name="title" value="3" <?= (@$info->title==3)?'checked':''?> />Ms 
			<input type="radio" name="title" value="4" <?= (@$info->title==4)?'checked':''?> />Miss 
			<input type="radio" name="title" value="5" <?= (@$info->title==5)?'checked':''?> />Dr 
			other (specify)
			<input type="text" name="title_other" value="<?= @$info->title_other?>"/></td>
        </tr>
        <tr class="even">
            <td>A3. Other names you are known by or have ever been known by</td>
            <td colspan="4"><input type="text" name="alias1" value="<?= @$info->alias1?>"/> <input type="text" name="alias2" value="<?= @$info->alias2?>"/></td>
        </tr>
        <tr class="odd">
            <td>A4. Your name in ethnic script</td>
			<td><input type="text" name="ethnic_script" value="<?= @$info->ethnic_script?>"/></td>
			<td>&nbsp;</td>
			<td>A5. Gender</td>
			<td><input type="radio" name="sex" value="1" <?= (@$info->sex==1)?'checked':''?> />Male 
        		<input type="radio" name="sex" value="2" <?= (@$info->sex==2)?'checked':''?> />Female</td>
        </tr>
        <tr class="even">
          <td>A6. Date of birth</td>
		  <td colspan="4"><input type="text" name="birth" id="birth" value="<?= @$info->birth?>"/>
		    DDMMYYYY</td>
        </tr>
        <tr class="odd">
            
            <td colspan="5">A7. Town/city of birth 
              	<input type="text" name="birth_city" value="<?= @$info->birth_city?>"/>              
               Country of birth 
              <input type="text" name="birth_country" value="<?= @$info->birth_country?>"/></td>
        </tr>
        <tr class="even">
            <td colspan="5">A8. Passport number 
              	<input type="text" name="travel_document_num" value="<?= @$info->travel_document_num?>" />              
               Expiry date 
               <input type="text" name="travel_document_valid_date" value="<?= @$info->travel_document_valid_date?>" id="travel_document_valid_date" />
(DDMMYYYY) &nbsp;&nbsp;Country 
<input type="text" name="travel_document_country" value="<?= @$info->travel_document_country?>" /></td>
        </tr>
        <tr class="odd">
            <td>A9. Country of citizenship</td>
            <td><input type="text" name="citizenship" value="<?= @$info->citizenship?>"/></td>
            <td>&nbsp;</td>
            <td>A10. Other citizenships you hold</td>
            <td><input type="text" name="citizenship_other" value="<?= @$info->citizenship_other?>"/></td>
        </tr>
        <tr class="even">
            <td>A11. Partnership status</td>
            <td colspan="4"><input type="radio" name="marital_status" value="1" <?= (@$info->marital_status==1)?'checked':''?> />
            	Married/in civil union
					<input type="radio" name="marital_status" value="2" <?= (@$info->marital_status==2)?'checked':''?> />
					Never married/never in civil union
					<input type="radio" name="marital_status" value="3" <?= (@$info->marital_status==3)?'checked':''?> />
					Partner<br />
					<input type="radio" name="marital_status" value="4" <?= (@$info->marital_status==4)?'checked':''?> />
					Separated
					<input type="radio" name="marital_status" value="5" <?= (@$info->marital_status==5)?'checked':''?> />
					Engaged
					<input type="radio" name="marital_status" value="6" <?= (@$info->marital_status==6)?'checked':''?> />
					Widowed
					<input type="radio" name="marital_status" value="7" <?= (@$info->marital_status==7)?'checked':''?> />
					Divorced</td>
        </tr>
		        <tr class="odd">
            <td colspan="5"><strong>Section B Contact details</strong></td>
		        </tr>
        <tr class="even">
            <td colspan="5">B1 Your residential address and telephone number in your home country.</td>
        </tr>		
        <tr class="even">
			<td>Address</td>
        	<td colspan="4"><input type="text" name="address" value="<?= @$info->address?>" style="width:300px"/></td>
        	</tr>
        <tr class="odd">
			<td>Telephone (daytime)</td>
        	<td><input type="text" name="tel1" value="<?= @$info->tel1?>"/></td>
        	<td>&nbsp;</td>
        	<td>Telephone (evening)</td>
        	<td><input type="text" name="tel2" value="<?= @$info->tel2?>"/></td>
        	</tr>
        <tr class="even">
			<td>Fax</td>
        	<td><input type="text" name="fax" value="<?= @$info->fax?>"/></td>
        	<td>&nbsp;</td>
        	<td>Email</td>
        	<td><input type="text" name="email" value="<?= @$info->email?>" id="email" /></td>
        	</tr>
        

        <tr class="odd">
            <td colspan="5">B2 Your New Zealand residential address and telephone number (if you are already in New Zealand).</td>
        </tr>
        <tr class="even">
			<td>Address</td>
        	<td colspan="4"><input type="text" name="nz_address" value="<?= @$info->nz_address?>" style="width:300px"/></td>
        	</tr>
        <tr class="odd">
			<td>Telephone (daytime)</td>
        	<td><input type="text" name="nz_tel1" value="<?= @$info->nz_tel1?>"/></td>
        	<td>&nbsp;</td>
        	<td>Telephone (evening)</td>
        	<td><input type="text" name="nz_tel2" value="<?= @$info->nz_tel2?>"/></td>
        	</tr>
        <tr class="even">
			<td>Fax</td>
        	<td><input type="text" name="nz_fax" value="<?= @$info->nz_fax?>"/></td>
        	<td>&nbsp;</td>
        	<td>Email</td>
        	<td><input type="text" name="nz_email" value="<?= @$info->nz_email?>" id="nz_email"/></td>
        	</tr>
        
        <tr class="odd">
            <td colspan="2">B3 Name and address for communication about this application.</td>
			<td colspan="3"><input type="radio" name="is_same_address" value="1" <?= (@$info->is_same_address==1)?'checked':''?> />
				Same as address at B1 , or
					<input type="radio" name="is_same_address" value="2" <?= (@$info->is_same_address==2)?'checked':''?> />
					Same as address at B2 , or
					<input type="radio" name="is_same_address" value="3" <?= (@$info->is_same_address==3)?'checked':''?> />
					as below</td>
        </tr>
        <tr class="odd">
			<td>Family/last name</td>
        	<td><input type="text" name="postal_family" value="<?= @$info->postal_family?>"/></td>
        	<td>&nbsp;</td>
        	<td>Given/first name(s)</td>
        	<td><input type="text" name="postal_given" value="<?= @$info->postal_given?>"/></td>
        	</tr>
        <tr class="even">
			<td>Company name (if applicable) and address</td>
        	<td colspan="4"><input type="text" name="postal_address" value="<?= @$info->postal_address?>" style="width:300px"/></td>
        	</tr>
        <tr class="odd">
			<td>Telephone (daytime)</td>
        	<td><input type="text" name="postal_tel1" value="<?= @$info->postal_tel1?>"/></td>
        	<td>&nbsp;</td>
        	<td>Telephone (evening)</td>
        	<td><input type="text" name="postal_tel2" value="<?= @$info->postal_tel2?>"/></td>
        	</tr>
        <tr class="even">
			<td>Fax</td>
        	<td><input type="text" name="postal_fax" value="<?= @$info->postal_fax?>"/></td>
        	<td>&nbsp;</td>
        	<td>Email</td>
        	<td><input type="text" name="postal_email" value="<?= @$info->postal_email?>" id="postal_email"/></td>
        	</tr>
        
        <tr class="even">
            <td colspan="2">B4 Do you authorise the person stated at B3 to act on your behalf?</td>
            <td colspan="3"><input type="radio" name="is_b4" value="1" <?= (@$info->is_b4==1)?'checked':''?> />Yes 
			<input type="radio" name="is_b4" value="0" <?= (@$info->is_b4==0)?'checked':''?> />No</td>
        </tr>
        <tr class="odd">
            <td colspan="2">B5 Have you received immigration advice on this application?</td>
			<td colspan="3">You can find a definition of immigration advice at www.immigration.govt.nz/advice.<br />
			  <input type="radio" name="is_b5" value="1" <?= (@$info->is_b5==1)?'checked':''?> />
Yes  &nbsp;Make sure that your immigration adviser completes ‘Section M: Immigration adviser’s details’.<br />
<input type="radio" name="is_b5" value="0" <?= (@$info->is_b5==0)?'checked':''?> />
No </td>
        </tr>
        <tr class="even">
            <td colspan="4">B6 Would you like us to email you instructions for registering to check online how your application is progressing?</td>
			<td><input type="radio" name="is_b6" value="1" <?= (@$info->is_b6==1)?'checked':''?> />
Yes
  <input type="radio" name="is_b6" value="0" <?= (@$info->is_b6==0)?'checked':''?> />
No </td>
        </tr>
        <tr class="odd">
            <td colspan="5">B7 Names and addresses of friends, relatives, or contacts you have in New Zealand (if applicable).</td>
        </tr>
		<tr class="even">
		<td>Name</td>
        	<td><input type="text" name="friend1_name" value="<?= @$info->friend1_name?>"/></td>
        	<td>&nbsp;</td>
        	<td>Relationship</td>
			<td><input type="text" name="friend1_relate" value="<?= @$info->friend1_relate?>"/></td>
        </tr>
        <tr class="even">
            <td>Address</td>
        	<td colspan="4"><input type="text" name="friend1_address" value="<?= @$info->friend1_address?>" style="width:300px"/></td>
        	</tr>
		<tr class="odd">
            <td>Name</td>
        	<td><input type="text" name="friend2_name" value="<?= @$info->friend2_name?>"/></td>
        	<td>&nbsp;</td>
        	<td>Relationship</td>
			<td><input type="text" name="friend2_relate" value="<?= @$info->friend2_relate?>"/></td>
        </tr>
        <tr class="even">
            <td>Address</td>
        	<td colspan="4"><input type="text" name="friend2_address" value="<?= @$info->friend2_address?>" style="width:300px"/></td>
		</tr>
        <tr class="even">
             <td colspan="5">B8 List all periods of employment, including self-employment</td>
        </tr>
		<tr class="odd">
		<td>Date from (DD/MM/YY)</td>
        	<td>Date to (DD/MM/YY)</td>
        	<td>Name of employer</td>
        	<td>Location</td>
			<td>Type of work/occupation/job title</td>
        </tr>
		<tr class="odd">
            <td nowrap="nowrap"><input type="text" name="emp1_from" id="emp1_from" value="<?= @$info->emp1_from?>"/></td>
        	<td nowrap="nowrap"><input type="text" name="emp1_to" id="emp1_to" value="<?= @$info->emp1_to?>"/></td>
        	<td><input type="text" name="emp1_name" value="<?= @$info->emp1_name?>"/></td>
        	<td><input type="text" name="emp1_loc" value="<?= @$info->emp1_loc?>"/></td>
			<td><input type="text" name="emp1_title" value="<?= @$info->emp1_title?>"/></td>
        </tr>
        <tr class="even">
            <td><input type="text" name="emp2_from" id="emp2_from" value="<?= @$info->emp2_from?>"/></td>
        	<td><input type="text" name="emp2_to" id="emp2_to" value="<?= @$info->emp2_to?>"/></td>
        	<td><input type="text" name="emp2_name" value="<?= @$info->emp2_name?>"/></td>
        	<td><input type="text" name="emp2_loc" value="<?= @$info->emp2_loc?>"/></td>
			<td><input type="text" name="emp2_title" value="<?= @$info->emp2_title?>"/></td>
        </tr>
		<tr class="odd">
            <td><input type="text" name="emp3_from" id="emp3_from" value="<?= @$info->emp3_from?>"/></td>
        	<td><input type="text" name="emp3_to" id="emp3_to" value="<?= @$info->emp3_to?>"/></td>
        	<td><input type="text" name="emp3_name" value="<?= @$info->emp3_name?>"/></td>
        	<td><input type="text" name="emp3_loc" value="<?= @$info->emp3_loc?>"/></td>
			<td><input type="text" name="emp3_title" value="<?= @$info->emp3_title?>"/></td>
        </tr>
        <tr class="even">
            <td><input type="text" name="emp4_from" id="emp4_from" value="<?= @$info->emp4_from?>"/></td>
        	<td><input type="text" name="emp4_to" id="emp4_to" value="<?= @$info->emp4_to?>"/></td>
        	<td><input type="text" name="emp4_name" value="<?= @$info->emp4_name?>"/></td>
        	<td><input type="text" name="emp4_loc" value="<?= @$info->emp4_loc?>"/></td>
			<td><input type="text" name="emp4_title" value="<?= @$info->emp4_title?>"/></td>
        </tr>
		<tr class="odd">
            <td><input type="text" name="emp5_from" id="emp5_from" value="<?= @$info->emp5_from?>"/></td>
        	<td><input type="text" name="emp5_to" id="emp5_to" value="<?= @$info->emp5_to?>"/></td>
        	<td><input type="text" name="emp5_name" value="<?= @$info->emp5_name?>"/></td>
        	<td><input type="text" name="emp5_loc" value="<?= @$info->emp5_loc?>"/></td>
			<td><input type="text" name="emp5_title" value="<?= @$info->emp5_title?>"/></td>
		</tr>
        <tr class="odd">
            <td colspan="5"><strong>Section C Your health</strong></td>
        </tr>
        <tr class="even">
            <td colspan="5">All applicants must complete this section.</td>
        </tr>
        <tr class="odd">
            <td colspan="5">For more information about the questions in this section, see ‘Completing Section C: Your health’ in the Student Visa Guide.</td>
        </tr>
        <tr class="even">
		    <td colspan="5">C1 Do you have pulmonary tuberculosis (TB)? 
		      &nbsp;&nbsp;&nbsp;
			  <input type="radio" name="is_c1" value="1" <?= (@$info->is_c1==1)?'checked':''?> />Yes Provide details  
			  <input type="radio" name="is_c1" value="0" <?= (@$info->is_c1==0)?'checked':''?> />No<br />
			  <textarea name="c1"><?= @$info->c1?></textarea></td>
        </tr>
        <tr class="odd">
            <td colspan="5">C2 Do you have any medical condition that requires, or may require, one of the following during your stay in New Zealand?<br />
              <table width="80%">
                <tr>
                  <td width="30%">• Renal dialysis</td>
                  <td width="70%">
				  <input type="radio" name="is_c2_1" value="1" <?= (@$info->is_c2_1==1)?'checked':''?> />Yes 
				  <input type="radio" name="is_c2_1" value="0" <?= (@$info->is_c2_1==0)?'checked':''?> />No				  </td>
                </tr>
                <tr>
                  <td>• Hospital care</td>
                  <td>
				  <input type="radio" name="is_c2_2" value="1" <?= (@$info->is_c2_2==1)?'checked':''?> />Yes 
				  <input type="radio" name="is_c2_2" value="0" <?= (@$info->is_c2_2==0)?'checked':''?> />No				  </td>
                </tr>
                <tr>
                  <td>• Residential care</td>
                  <td>
				  <input type="radio" name="is_c2_3" value="1" <?= (@$info->is_c2_3==1)?'checked':''?> />Yes 
				  <input type="radio" name="is_c2_3" value="0" <?= (@$info->is_c2_3==0)?'checked':''?> />No				  </td>
                </tr>
              </table></td>
        </tr>
		
		<tr class="even">
            <td colspan="5">C3 If you have answered Yes to any of the questions in C2 , provide details.<br />
              <textarea name="c3"><?= @$info->c3?></textarea></td>
		</tr>
		
		<tr class="odd">
            <td>C4 Are you pregnant?</td>
			<td colspan="4"><input type="radio" name="is_c4" value="1" <?= (@$info->is_c4==1)?'checked':''?> />
Yes  &nbsp;&nbsp;&nbsp; Date you are due to give birth 
<input type="text" name="c4" value="<?= @$info->c4?>" id="c4"/> 
(DDMMYYYY) 
 Go to C5<br />
<input type="radio" name="is_c4" value="0" <?= (@$info->is_c4==0)?'checked':''?> />
No  &nbsp;&nbsp;&nbsp; Go to C8</td>
		</tr>
		
		<tr class="even">
            <td colspan="2">C5 Do you intend to give birth in New Zealand?</td>
			<td colspan="3"><input type="radio" name="is_c5" value="1" <?= (@$info->is_c5==1)?'checked':''?> />
Yes  &nbsp;&nbsp;&nbsp;Go to C6
<input type="radio" name="is_c5" value="0" <?= (@$info->is_c5==0)?'checked':''?> />
No  &nbsp;&nbsp;&nbsp; Go to C8</td>
		</tr>
		
		<tr class="odd">
            <td colspan="5">C6 Are you, or will you be eligible for publicly-funded maternity health services? <br/>
			<input type="radio" name="is_c6" value="1" <?= (@$info->is_c6==1)?'checked':''?> />
Yes  &nbsp;&nbsp;&nbsp; Explain why you are, or will be eligible and what evidence you have provided to demonstrate eligibility<br />
 <input type="radio" name="is_c6" value="0" <?= (@$info->is_c6==0)?'checked':''?> />
No  &nbsp;&nbsp;&nbsp; Go to C7
			<br />
			<textarea name="c6"><?= @$info->c6?></textarea></td>
		</tr>
		
		<tr class="even">
            <td colspan="5">C7 Please tick one of the options below to show what evidence you are providing to demonstrate how you will meet the cost of maternity health services.<br />
              <input type="radio" name="is_c7" value="1" <?= (@$info->is_c7==1)?'checked':''?> />
              I have attached copies (not originals) of evidence that I have at least NZ$9,000 to pay for maternity health services.<br />
              <input type="radio" name="is_c7" value="2" <?= (@$info->is_c7==2)?'checked':''?> />              
               I have attached a completed Sponsorship Form for Temporary Entry (INZ 1025) guaranteeing that the cost of maternity health services will be met by my sponsor.<br />
              <input type="radio" name="is_c7" value="3" <?= (@$info->is_c7==3)?'checked':''?> />              
              I have attached a Financial Undertaking for a Student (INZ 1014) completed by a third party guarantor accepting responsibility for the cost of maternity health services.</td>
		</tr>
		
		<tr class="odd">
            <td colspan="5"><strong>Medical certificates you must provide</strong></td>
		</tr>
		
		<tr class="even">
            <td colspan="5">C8 Do you intend to study in New Zealand for less than six months? If you are in New Zealand, this includes time you have already spent here.<br />
              <table width="90%">
                <tr>
                  <td width="8%"><input type="radio" name="is_c8" value="1" <?= (@$info->is_c8==1)?'checked':''?> />
Yes  </td>
                  <td width="92%"><label>You do not need to provide a medical certificate. Go to C14</label></td>
                </tr>
                <tr>
                  <td><input type="radio" name="is_c8" value="0" <?= (@$info->is_c8==0)?'checked':''?> />
No   </td>
                  <td>Go to C9</td>
                </tr>
              </table>              </td>
		</tr>
		
		<tr class="odd">
            <td colspan="5">C9 Have you submitted a medical certificate with another Immigration New Zealand application?<br />
			   <table width="90%">
                <tr>
                  <td width="8%"><input type="radio" name="is_c9" value="1" <?= (@$info->is_c9==1)?'checked':''?> />
Yes   </td>
                  <td width="92%">Provide details then go to C10<br />
                    Type of application 
                    <input type="text" name="c9_1" value="<?= @$info->c9_1?>"/>                    
                     Date of application 
                    <input type="text" name="c9_2" value="<?= @$info->c9_2?>" id="c9_2"/>
                    ddmmyyyy</td>
                </tr>
                <tr>
                  <td><input type="radio" name="is_c9" value="0" <?= (@$info->is_c9==0)?'checked':''?> />
No   </td>
                  <td>Go to C11</td>
                </tr>
              </table>			</td>
		</tr>
		
		<tr class="even">
            <td colspan="5">C10 Was the medical certificate completed and dated by a medical practitioner:<br />
              • within the last 36 months if you are a full fee-paying or PhD student, or<br />
              • within the last 24 months if you are not a full fee-paying or PhD student?<br />
              <table width="90%">
                <tr>
                  <td width="8%"><input type="radio" name="is_c10" value="1" <?= (@$info->is_c10==1)?'checked':''?> />
                    Yes </td>
                  <td width="92%">You do not need to provide a further medical certificate now. We will tell you if we need any further information, such as tests, reports, or
                    a new medical certificate. Go to C14</td>
                </tr>
                <tr>
                  <td><input type="radio" name="is_c10" value="0" <?= (@$info->is_c10==0)?'checked':''?> />
                    No </td>
                  <td>Go to C11</td>
                </tr>
              </table></td>
		</tr>
		
		<tr class="odd">
            <td colspan="5">C11 How long do you intend to stay in New Zealand? If you are in New Zealand, this includes time you have already spent here.<br />
               &nbsp;<input type="radio" name="is_c11" value="1" <?= (@$info->is_c11==1)?'checked':''?> />                More than six months but not more than 12 months. Go to C12<br />
               &nbsp;<input type="radio" name="is_c11" value="2" <?= (@$info->is_c11==2)?'checked':''?> />
               More than 12 months. You must provide a Medical and Chest X-ray Certificate (INZ 1007). Go to C14</td>
		</tr>
		
		<tr class="even">
            <td colspan="5">C12 See the list ‘Countries, areas, and territories with a low incidence of tuberculosis’ in ‘Completing Section C: Your health’ of the Student Visa Guide. Please tick one of the options below.<br />
              &nbsp;<input type="radio" name="is_c12" value="1" <?= (@$info->is_c12==1)?'checked':''?> />               I am from a place that is on the list. Go to C13<br />
              &nbsp;<input type="radio" name="is_c12" value="2" <?= (@$info->is_c12==2)?'checked':''?> />
I am from a place that is not on the list. Write the name of the place below. You must provide a completed X-ray Certificate for Temporary Entry (INZ 1096) with your application. Go to C14<br />
Name of country, area or territory 
<input name="c12" type="text" value="<?= @$info->c12?>" style="width:300px"/></td>
		</tr>
		
		<tr class="odd">
            <td colspan="5">C13 Tick one of the options below.<br />
              &nbsp;<input type="radio" name="is_c13" value="1" <?= (@$info->is_c13==1)?'checked':''?> />
              I have not spent three months or more in the past five years in a place that is not on the list. You do not have to provide a medical certificate at this stage. Go to C14<br />
&nbsp;<input type="radio" name="is_c13" value="2" <?= (@$info->is_c13==2)?'checked':''?> />
I have spent three months or more in the past five years in a place that is not on the list. Provide details
<input name="c13" type="text" value="<?= @$info->c13?>" style="width:300px"/>
<br />
You must provide a completed X-ray Certificate for Temporary Entry (INZ 1096) with your application. Go to C14</td>
		</tr>
		
		<tr class="even">
            <td colspan="5">C14 Tick one of the options below.<br />
              &nbsp;<input type="radio" name="is_c14" value="1" <?= (@$info->is_c14==1)?'checked':''?> />
              I do not have to provide a medical certificate at this stage.<br />
              &nbsp;<input type="radio" name="is_c14" value="2" <?= (@$info->is_c14==2)?'checked':''?> />
              I attach an X-ray Certificate for Temporary Entry (INZ 1096).<br />
              &nbsp;<input type="radio" name="is_c14" value="3" <?= (@$info->is_c14==3)?'checked':''?> />
              I attach a Medical and Chest X-ray Certificate (INZ 1007).<br />
              Note that children under the age of 11 years and pregnant women are not required to have an X-ray, unless a special report is needed.</td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5" valign="top"><strong>Section D Your character</strong></td>
		</tr>
		
		<tr class="even">
		    <td colspan="5">All applicants must complete this section. Note: if your application is declined for character reasons, Immigration New Zealand may place a notation in your passport indicating that you applied for a visa for New Zealand.</td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5">D1 Have you been:<br />
		      <table width="50%">
                <tr>
                  <td width="34%">• convicted</td>
                  <td width="66%"><input type="radio" name="is_d1_1" value="1" <?= (@$info->is_d1_1==1)?'checked':''?> />
                    Yes
                    <input type="radio" name="is_d1_1" value="0" <?= (@$info->is_d1_1==0)?'checked':''?> />
                    No </td>
                </tr>
                <tr>
                  <td>• charged</td>
                  <td><input type="radio" name="is_d1_2" value="1" <?= (@$info->is_d1_2==1)?'checked':''?> />
                    Yes
                    <input type="radio" name="is_d1_2" value="0" <?= (@$info->is_d1_2==0)?'checked':''?> />
                    No </td>
                </tr>
                <tr>
                  <td>• under investigation</td>
                  <td><input type="radio" name="is_d1_3" value="1" <?= (@$info->is_d1_3==1)?'checked':''?> />
                    Yes
                    <input type="radio" name="is_d1_3" value="0" <?= (@$info->is_d1_3==0)?'checked':''?> />
                    No </td>
                </tr>
              </table>
		     
		      for any offence(s) against the law in any country? </td>
		</tr>
		
		<tr class="even">
		    <td colspan="5">D2 Have you been:<br />
              <table width="50%">
                <tr>
                  <td width="41%">• excluded (refused entry) from</td>
                  <td width="59%"><input type="radio" name="is_d2_1" value="1" <?= (@$info->is_d2_1==1)?'checked':''?> />
                    Yes
                    <input type="radio" name="is_d2_1" value="0" <?= (@$info->is_d2_1==0)?'checked':''?> />
                    No </td>
                </tr>
                <tr>
                  <td>• refused a visa by</td>
                  <td><input type="radio" name="is_d2_2" value="1" <?= (@$info->is_d2_2==1)?'checked':''?> />
                    Yes
                    <input type="radio" name="is_d2_2" value="0" <?= (@$info->is_d2_2==0)?'checked':''?> />
                    No </td>
                </tr>
                <tr>
                  <td>• removed or deported from</td>
                  <td><input type="radio" name="is_d2_3" value="1" <?= (@$info->is_d2_3==1)?'checked':''?> />
                    Yes
                    <input type="radio" name="is_d2_3" value="0" <?= (@$info->is_d2_3==0)?'checked':''?> />
                    No </td>
                </tr>
              </table>
              any country?<br />
              If you have answered Yes to any of the questions in D1 and D2 , provide details below.<br />
              <textarea name="d2"><?= @$info->d2?></textarea></td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5">D3 Do you intend to study in New Zealand for 24 months or longer? If you are in New Zealand, this includes time you
have already spent here.<br />
<table width="90%">
  <tr>
    <td width="8%"><input type="radio" name="is_d3" value="1" <?= (@$info->is_d3==1)?'checked':''?> />
      Yes </td>
    <td width="92%">Go to D4</td>
  </tr>
  <tr>
    <td><input type="radio" name="is_d3" value="0" <?= (@$info->is_d3==0)?'checked':''?> />
      No </td>
    <td>You do not need to provide any police certificates at this stage. Go to Section E: Your visa.</td>
  </tr>
</table></td>
		</tr>
		
		<tr class="even">
		    <td colspan="5">D4 Are you 17 years or over?<br />
<table width="90%">
  <tr>
    <td width="8%"><input type="radio" name="is_d4" value="1" <?= (@$info->is_d4==1)?'checked':''?> />
      Yes </td>
    <td width="92%">Go to D5</td>
  </tr>
  <tr>
    <td><input type="radio" name="is_d4" value="0" <?= (@$info->is_d4==0)?'checked':''?> />
      No </td>
    <td>You do not need to provide evidence about your character. Go to Section E: Your visa.</td>
  </tr>
</table></td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5">D5 Have you submitted a police certificate with another Immigration New Zealand application?<br />
		      <table width="90%">
                <tr>
                  <td width="8%"><input type="radio" name="is_d5" value="1" <?= (@$info->is_d5==1)?'checked':''?> />
                    Yes </td>
                  <td width="92%">Provide details</td>
                </tr>
                <tr>
                  <td><input type="radio" name="is_d5" value="0" <?= (@$info->is_d5==0)?'checked':''?> />
                    No </td>
                  <td>Go to D7</td>
                </tr>
              </table>
		      Type of application 
		      <input name="d5_1" type="text" value="<?= @$info->d5_1?>"/>		      
		       Date of application 
		       <input name="d5_2" type="text" value="<?= @$info->d5_2?>" id="d5_2"/> 
			(DDMMYYYY) </td>
		</tr>
		
		<tr class="even">
		    <td colspan="5">D6 Was the police certificate issued:
              <br />
              • within the last 36 months if you are a full fee-paying or PhD student, or
              <br />
              • within the last 24 months if you are not a full fee-paying or PhD student?<br />
              <table width="90%">
                <tr>
                  <td width="8%"><input type="radio" name="is_d6" value="1" <?= (@$info->is_d6==1)?'checked':''?> />
                    Yes </td>
                  <td width="92%">We will tell you if we need any further information about your character. Go to Section E: Your visa.</td>
                </tr>
                <tr>
                  <td><input type="radio" name="is_d6" value="0" <?= (@$info->is_d6==0)?'checked':''?> />
                    No </td>
                  <td>&nbsp;</td>
                </tr>
              </table></td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5">D7 You must provide evidence about your character. Tick to confirm what evidence you have provided.<br />
		      &nbsp;<input type="radio" name="is_d7" value="1" <?= (@$info->is_d7==1)?'checked':''?> />
		      I have attached police certificates from my country or countries of citizenship, and<br />
&nbsp;<input type="radio" name="is_d7" value="2" <?= (@$info->is_d7==2)?'checked':''?> />
I have attached police certificates from all countries I have lived in for five years or more since the age of 17.</td>
		</tr>
		
		<tr class="even">
		    <td colspan="5">D8 If you have not provided all of the police certificates required, explain why.<br />
		      <textarea name="d8"><?= @$info->d8?></textarea></td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5"><strong>Section E Your visa</strong></td>
		</tr>
		
		<tr class="even">
		    <td colspan="5">For more information about the questions in this section, see ‘Completing Section E: Your visa’ in the Student Visa Guide.</td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5">E1 Tick one of the boxes below to show the type of visa you are applying for and provide the date of your arrival in New Zealand if applicable.<br />
		      &nbsp;<input type="radio" name="is_e1" value="1" <?= (@$info->is_e1==1)?'checked':''?> />
		      Applying for a student visa while outside New Zealand. Date you will enter New Zealand (if applicable)  
		      <input name="e1_1" type="text" value="<?= @$info->e1_1?>" id="e1_1"/>
(DDMMYYYY) <br />
		      &nbsp;<input type="radio" name="is_e1" value="2" <?= (@$info->is_e1==2)?'checked':''?> />
		      Applying for a student visa while inside New Zealand. <br />
		      Note: student visas normally allow multiple entry travel.<br />
		      &nbsp;<input type="radio" name="is_e1" value="3" <?= (@$info->is_e1==3)?'checked':''?> />
		      Applying for a limited visa. List the reasons below. Date you will enter New Zealand on a limited visa 
		      <input name="e1_2" type="text" value="<?= @$info->e1_2?>" id="e1_2"/>
(DDMMYYYY) <br />
		      &nbsp;<input type="radio" name="is_e1" value="4" <?= (@$info->is_e1==4)?'checked':''?> />		       Applying for a further limited visa. List the reasons below.<br />
		      <textarea name="e1_3"><?= @$info->e1_3?></textarea></td>
		</tr>
		
		<tr class="even">
		    <td colspan="5">E2 If you are applying for a variation of conditions to work as part of your application, tick one or more of the options below.<br />
		      &nbsp;<input type="radio" name="is_e2" value="1" <?= (@$info->is_e2==1)?'checked':''?> />
		      I want to be allowed to work up to 20 hours in any week during the academic year.<br />
		      &nbsp;<input type="radio" name="is_e2" value="2" <?= (@$info->is_e2==2)?'checked':''?> />
		      I want to be allowed to work full-time during the Christmas and New Year holiday period. </td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5">E3 If you are not studying at secondary school in Years 12 or 13, go to Section F: Your course of study.<br />
		      If you are studying at secondary school in Years 12 or 13, tick the box or boxes that apply to you:<br />
		      &nbsp;<input type="radio" name="is_e3" value="1" <?= (@$info->is_e3==1)?'checked':''?> />
		      I want to be allowed to work up to 20 hours in any week during the academic year and I have attached written permission from my parent(s) and school enabling me to work.<br />
		      I want to be allowed to work full-time during the Christmas and New Year holiday period and I am:<br />
		      &nbsp;<input type="radio" name="is_e3" value="2" <?= (@$info->is_e3==2)?'checked':''?> />
		      17 years of age or under and have attached written permission from my parent(s) and school enabling me to work.<br />
		      &nbsp;<input type="radio" name="is_e3" value="3" <?= (@$info->is_e3==3)?'checked':''?> />
18 years of age or over and have attached written permission from my parent(s) enabling me to work.</td>
		</tr>
		
		<tr class="even">
		    <td colspan="5"><strong>Section F Your course of study</strong></td>
		</tr>
		
		<tr class="odd">
		    <td colspan="5">All applicants must complete this section, apart from:<br />
		      • dependent children with domestic student status<br />
		      • partners of work visa holders.<br />
		      For more information about the questions in this section, see ‘Completing Section F: Your course of study’ in the Student Visa Guide.</td>
		</tr>
		
		<tr class="even">
		    <td>F1 When does your course start?</td>
			<td colspan="4"><input name="f1" type="text" value="<?= @$info->f1?>" id="f1"/> 
			(DDMMYYYY) </td>
		</tr>
		
		<tr class="odd">
		    <td>F2 When does your course finish?</td>
			<td colspan="4"><input name="f2" type="text" value="<?= @$info->f2?>" id="f2"/> 
			(DDMMYYYY) </td>
		</tr>
		
		<tr class="even">
		   <td colspan="2">F3 Provide the date to which your course fees have been paid. If you have a scholarship, provide the date your scholarship ends</td>
			<td colspan="3"><input name="f3" type="text" value="<?= @$info->f3?>" id="f3"/> 
			(DDMMYYYY) </td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">F4 Details of the course or courses you have enrolled in<br />
		     Name of institution where you will be studying 
		       <input name="f4_1_1" type="text" value="<?= @$info->f4_1_1?>"/>
		       <br />
		       Qualification you will be studying 
		       <input name="f4_1_2" type="text" value="<?= @$info->f4_1_2?>"/>
		       <br />
		       Location of the institution in New Zealand where you will be studying<input name="f4_1_3" type="text" value="<?= @$info->f4_1_3?>" />
		       <br />
		       <br />
		       Name of institution where you will be studying
               <input name="f4_2_1" type="text" value="<?= @$info->f4_2_1?>"/>
				<br />
				Qualification you will be studying
<input name="f4_2_2" type="text" value="<?= @$info->f4_2_2?>"/>
<br />
Location of the institution in New Zealand where you will be studying
<input name="f4_2_3" type="text" value="<?= @$info->f4_2_3?>"/>
<br />
<br />
Name of institution where you will be studying
<input name="f4_3_1" type="text" value="<?= @$info->f4_3_1?>"/>
<br />
Qualification you will be studying
<input name="f4_3_2" type="text" value="<?= @$info->f4_3_2?>"/>
<br />
Location of the institution in New Zealand where you will be studying
<input name="f4_3_3" type="text" value="<?= @$info->f4_3_3?>"/></td>
		</tr>
		
		<tr class="even">
		   <td colspan="5"><strong>Your offer of a place or confirmation of enrolment</strong></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5" valign="top">F5 I have attached an offer of a place or confirmation of enrolment at a New Zealand education institute. 
		     <label>
		     <input type="checkbox" name="is_f5" value="1" <?= (@$info->is_f5==1)?'checked':''?>/>
		     </label>		     </td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">F6 Tick one of the options below<br />
		     &nbsp;<input type="radio" name="is_f6" value="1" <?= (@$info->is_f6==1)?'checked':''?> />
		     I have attached evidence that I have paid the course fees.<br />
		     &nbsp;<input type="radio" name="is_f6" value="2" <?= (@$info->is_f6==2)?'checked':''?> />
		     I have attached evidence that I am exempt from paying the course fees. (If you have been accepted on an approved student exchange scheme, attach evidence from the scheme organiser that you have been accepted.)<br />
		     &nbsp;<input type="radio" name="is_f6" value="3" <?= (@$info->is_f6==3)?'checked':''?> />		      I will provide evidence that I have paid the course fees once this application is approved in principle.<br />
		     This option is only available to applicants who have not completed, or will not be completing the course of study endorsed on their student visa, and who wish to change their course of study and/or education provider. </td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">F7 If you already hold a student visa and you are applying for a further student visa, you must provide additional evidence. Please send photocopies, not original documents.<br />
&nbsp;
<input type="radio" name="is_f7" value="1" <?= (@$info->is_f7==1)?'checked':''?> />
I have attached evidence of my previous student performance.<br />
&nbsp;
<input type="radio" name="is_f7" value="2" <?= (@$info->is_f7==2)?'checked':''?> />
I have attached evidence of satisfactory attendance and progress.<br />
&nbsp;
<input type="radio" name="is_f7" value="3" <?= (@$info->is_f7==3)?'checked':''?> />
Not applicable.</td>
		</tr>
		
		<tr class="even">
		   <td colspan="5"><strong>Section G Financial support while you are in New Zealand</strong></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">All applicants must complete this section, apart from:<br />
		     • dependent children with domestic student status<br />
		     • people applying for a student visa on the basis of their partner’s immigration status (this includes partners of<br />
		     New Zealand citizens and residence class visa holders, and partners of some work visa holders).<br />
		     For more information about the questions in this section, see ‘Completing Section G: Financial support while you are in New Zealand’ in the Student Visa Guide.</td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">G1 Tick the box or boxes that apply to you.<br />
		    &nbsp;<input type="checkbox" name="g1[]" value="1" <?= (in_array('1',@$info->g1))?'checked="checked"':''?> />
		    I have attached a completed Financial Undertaking for a Student (INZ 1014).<br />
		    &nbsp;<input type="checkbox" name="g1[]" value="2" <?= (in_array('2',@$info->g1))?'checked="checked"':''?> />
		    I have attached a Sponsorship Form for Temporary Entry (INZ 1025) completed by an acceptable sponsor.<br />
		    &nbsp;<input type="checkbox" name="g1[]" value="3" <?= (in_array('3',@$info->g1))?'checked="checked"':''?> />
		    I have attached copies (not originals) of evidence that I have sufficient funds.<br />
		    &nbsp;<input type="checkbox" name="g1[]" value="4" <?= (in_array('4',@$info->g1))?'checked="checked"':''?> />
			I have attached copies (not originals) of evidence that my living costs are already paid. <br />
		    &nbsp;<input type="checkbox" name="g1[]" value="5" <?= (in_array('5',@$info->g1))?'checked="checked"':''?> />    
		     I have attached a written guarantee of maintenance from a relative in New Zealand who is either a New Zealand citizen or residence class visa holder. This option is for students from Tonga or Samoa only.</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">G2 What arrangements have you made for outward travel from New Zealand?<br />
		     <textarea name="g2"><?= @$info->g2?></textarea></td>
		</tr>
		
		<tr class="even">
		   <td colspan="2">G3 If you are 17 or younger, have you provided confirmation from your education provider that your accommodation arrangements meet the Code of Practice for the Pastoral Care of International Students?</td>
		   <td colspan="3">
		     <input type="radio" name="is_g3" value="1" <?= (@$info->is_g3==1)?'checked':''?> />		      Yes<br />
		     <input type="radio" name="is_g3" value="0" <?= (@$info->is_g3==0)?'checked':''?> />
		     No<br />
		     <input type="radio" name="is_g3" value="2" <?= (@$info->is_g3==2)?'checked':''?> />		      Not applicable because I am 18 or over.</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5"><strong>Section H Your parent or legal guardian</strong></td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">See ‘Completing Section H: Your parent or legal guardian’ in the Student Visa Guide to find out if you have to complete this section and for more information about the questions. If you do not have to complete this section, go to Section I: Dependent children of Essential Skills or Religious Worker work visa holders.</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">H1 Name of legal guardian as shown in their passport</td>
		</tr>
		
		<tr class="even">
		   <td>Family/last name</td>
		   <td><input name="h1_1" type="text" value="<?= @$info->h1_1?>"/></td>
		   <td>&nbsp;</td>
		   <td>Given/first name(s)</td>
		   <td><input name="h1_2" type="text" value="<?= @$info->h1_2?>"/></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="2">H2 Other names your legal guardian is known by</td>
		   <td colspan="3"><input name="h2" type="text" value="<?= @$info->h2?>"/></td>
		</tr>
		
		<tr class="even">
		  <td>H3 Gender</td>
		   <td><input type="radio" name="is_h3" value="1" <?= (@$info->is_h3==1)?'checked':''?> />
		     Male 
		     <input type="radio" name="is_h3" value="2" <?= (@$info->is_h3==2)?'checked':''?> /> Female</td>
		   <td>&nbsp;</td>
		   <td>H4 Date of birth</td>
		   <td><input name="h4" type="text" value="<?= @$info->h4?>" id="h4"/> 
			(DDMMYYYY) </td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">H5 Place of birth 
		     <input name="h5_1" type="text" value="<?= @$info->h5_1?>"/>		     
		      &nbsp;&nbsp;Country of birth 
		      <input name="h5_2" type="text" value="<?= @$info->h5_2?>"/></td>
		</tr>
		
		<tr class="even">
		   <td>H6 Passport details</td>
		   <td colspan="4">Number 
		     <input name="h6_1" type="text" value="<?= @$info->h6_1?>"/>
		     <br />
		     Country 
		     <input name="h6_2" type="text" value="<?= @$info->h6_2?>"/>		      
		     &nbsp;&nbsp;Expiry date 
		     <input name="h6_3" type="text" value="<?= @$info->h6_3?>" id="h6_3"/>
(DDMMYYYY) </td>
		</tr>
		
		<tr class="odd">
		   <td>H7 Country of citizenship</td>
		   <td colspan="4"><input name="h7" type="text" value="<?= @$info->h7?>"/></td>
		</tr>
		
		<tr class="even">
		   <td colspan="2">H8 Other citizenships your parent or legal guardian holds</td>
		   <td colspan="3"><input name="h8" type="text" value="<?= @$info->h8?>"/></td>
		</tr>
		
		<tr class="odd">
		   <td>H9 Relationship to you:</td>
		   <td colspan="4"><input type="radio" name="is_h9" value="1" <?= (@$info->is_h9==1)?'checked':''?> />
		     Mother 
		     <input type="radio" name="is_h9" value="2" <?= (@$info->is_h9==2)?'checked':''?> />
Father 
<input type="radio" name="is_h9" value="3" <?= (@$info->is_h9==3)?'checked':''?> />
Legal guardian </td>
		</tr>
		
		<tr class="even">
		   <td colspan="5"><strong>Documents you must provide about your parent or legal guardian</strong></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="4">H10 Have you attached evidence that your legal guardian cares for you in your home country?</td>
		   <td><input type="radio" name="is_h10" value="1" <?= (@$info->is_h10==1)?'checked':''?> />
		     Yes
		      <input type="radio" name="is_h10" value="0" <?= (@$info->is_h10==0)?'checked':''?> />
		      No</td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">H11 Tick one of the following:<br />
		     &nbsp;<input type="radio" name="is_h11" value="1" <?= (@$info->is_h11==1)?'checked':''?> />
		     I am to be treated as a domestic student because of my parent or legal guardian’s immigration status, and I have included evidence about my legal guardian.<br />
		     &nbsp;<input type="radio" name="is_h11" value="2" <?= (@$info->is_h11==2)?'checked':''?> />
		     I must be accompanied by a legal guardian and I have included evidence about my legal guardian.<br />
		     &nbsp;<input type="radio" name="is_h11" value="3" <?= (@$info->is_h11==3)?'checked':''?> />
		     Not applicable.</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5"><strong>Section I Dependent children of Essential Skills or Religious Worker work visa holders</strong></td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">Complete these questions if you are the dependent child of an Essential Skills or Religious Worker work visa holder(s).<br />
		     If you do not have to complete this section, go to Section J: Partnership Instructions.</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">I1 Provide the following information about your parent(s).<br />
		     Name of parent(s) as shown in passport 
		     <input name="i1_1_1" type="text" value="<?= @$info->i1_1_1?>"/>		     
		      Date of birth of parent(s)(DD/MM/YY) 
		      <input name="i1_1_2" type="text" value="<?= @$info->i1_1_2?>" id="i1_1_2"/>
		      <br />
		      INZ client number for parent(s) (if known) 
		      <input name="i1_1_3" type="text" value="<?= @$info->i1_1_3?>"/>
		      <br />
		      <br />
		      Name of parent(s) as shown in passport
              <input name="i1_2_1" type="text" value="<?= @$info->i1_2_1?>"/>
Date of birth of parent(s)(DD/MM/YY)
<input name="i1_2_2" type="text" value="<?= @$info->i1_2_2?>" id="i1_2_2"/>
<br />
INZ client number for parent(s) (if known)
<input name="i1_2_3" type="text" value="<?= @$info->i1_2_3?>"/></td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">Dependent children of Essential Skills work visa holders Go to I3</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">I2 If you are the dependent child of a Religious Worker work visa holder tick one of the following:<br />
&nbsp;
<input type="radio" name="is_i2" value="1" <?= (@$info->is_i2==1)?'checked':''?> />
I will be supported by the salary or wages of my parent(s).<br />
&nbsp;
<input type="radio" name="is_i2" value="2" <?= (@$info->is_i2==2)?'checked':''?> />
I will be supported by the religious organisation sponsoring my parent’s Religious Worker work visa. Go to Section L: Declaration by applicant.</td>
		</tr>
		
		<tr class="even">
		   <td colspan="4">I3 Do your parent(s) meet the minimum income threshold? Note: Under Religious Worker instructions the salary or wages of both parents can be counted toward the minimum income threshold. Under Essential Skills work visa instructions both parents must hold an Essential Skills work visa for the salary or wages of both parents to be counted toward the minimum income threshold. The minimum income threshold can be found in ‘Completing Section I: Dependent children of Essential Skills or Religious Worker work visa holders’ in the Student Visa Guide.</td>
		   <td><input type="radio" name="is_i3" value="1" <?= (@$info->is_i3==1)?'checked':''?> />
Yes
  <input type="radio" name="is_i3" value="0" <?= (@$info->is_i3==0)?'checked':''?> />
No</td>
		</tr>
		
		<tr class="odd">
		    <td colspan="4">I4 Have you provided evidence of the salary or wages earned by your parent(s)? Acceptable evidence includes original or certified copies of an employment agreement and/or description of the work with salary or wages equal to or higher than the minimum income threshold.</td>
		    <td><input type="radio" name="is_i4" value="1" <?= (@$info->is_i4==1)?'checked':''?> />
Yes
  <input type="radio" name="is_i4" value="0" <?= (@$info->is_i4==0)?'checked':''?> />
No</td>
		</tr>
		
		<tr class="even">
		   <td colspan="5"><strong>Section J Partnership Instructions</strong></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">Complete this section if you are applying for a student visa on the basis of your partner’s immigration status. See‘Completing Section J: Partnership Instructions’ in the Student Visa Guide to find out if you have to complete this section and for more information about the questions.</td>
		</tr>
		
		<tr class="even">
		   <td colspan="2">J1 Does your partner support your application?</td>
		   <td colspan="3">
  <input type="radio" name="is_j1" value="1" <?= (@$info->is_j1==1)?'checked':''?> />
Yes
  <input type="radio" name="is_j1" value="0" <?= (@$info->is_j1==0)?'checked':''?> />
No</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="2">J2 Are you and your partner living together in a genuine and stable partnership?</td>
		   <td colspan="3">
  <input type="radio" name="is_j2" value="1" <?= (@$info->is_j2==1)?'checked':''?> />
Yes
  <input type="radio" name="is_j2" value="0" <?= (@$info->is_j2==0)?'checked':''?> />
No &nbsp;&nbsp;Explain why you have answered No.<br />
<textarea name="j2"><?= @$info->j2?></textarea></td>
		</tr>
		
		<tr class="even">
		   <td colspan="4">J3 Do you and your partner meet the minimum requirements for the recognition of a partnership?</td>
		    <td>
  <input type="radio" name="is_j3" value="1" <?= (@$info->is_j3==1)?'checked':''?> />
Yes
  <input type="radio" name="is_j3" value="0" <?= (@$info->is_j3==0)?'checked':''?> />
No</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">For more information about the minimum requirements for the recognition of a partnership see ‘Completing Section J: Partnership Instructions’ in the Student Visa Guide.</td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">Partnership evidence you must provide</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">J4 Tick the box to confirm that you have attached the evidence we require.<br />
		     &nbsp;<input type="checkbox" name="j4[]" value="1" <?= (in_array('1',@$info->j4))?'checked="checked"':''?> />
		     I have attached a completed Form for Partners Supporting Partnership-Based Temporary Entry Applications (INZ 1146). (Not required for partners of military visa holders).<br />
		     &nbsp;<input type="checkbox" name="j4[]" value="2" <?= (in_array('2',@$info->j4))?'checked="checked"':''?> />
			 I have attached copies (not originals) of evidence that I am living with my partner in a genuine and stable partnership.</td>
		</tr>
		
		<tr class="even">
		   <td colspan="5"><strong>Section K Additional details</strong></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">Complete this section if you are 17 years or over. If you are under 17 years of age, go to Section M: Declaration by applicant.</td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">K1 Do you have a national identity number, or other unique identifier that was granted to you by any government?<br />
		     <table width="90%">
               <tr>
                 <td width="8%"><input type="radio" name="is_k1" value="1" <?= (@$info->is_k1==1)?'checked':''?> />
                   Yes </td>
                 <td width="92%">National identity number/unique identifier 
                   <input name="k1" type="text" value="<?= @$info->k1?>"/></td>
               </tr>
               <tr>
                 <td><input type="radio" name="is_k1" value="0" <?= (@$info->is_k1==0)?'checked':''?> />
                   No </td>
                 <td>&nbsp;</td>
               </tr>
             </table></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">K2 Have you completed military service in any country?<br />
		     <table width="100%">
               <tr>
                 <td width="8%"><input type="radio" name="is_k2" value="0" <?= (@$info->is_k2==0)?'checked':''?> />
                   No </td>
                 <td width="92%">&nbsp;</td>
               </tr>
               <tr>
                 <td><input type="radio" name="is_k2" value="1" <?= (@$info->is_k2==1)?'checked':''?> />
                   Yes </td>
                 <td>Provide information about your military service including the dates of your military service, your position and rank, the unit or units that you served in, and your role within each unit.<br />
	Date from(dd/mm/yy ) 
	<input name="k2_1_1" type="text" value="<?= @$info->k2_1_1?>" id="k2_1_1"/>                   
	Date to(dd/mm/yy ) 
	<input name="k2_1_2" type="text" value="<?= @$info->k2_1_2?>" id="k2_1_2"/>
	<br />
	Rank 
	<input name="k2_1_3" type="text" value="<?= @$info->k2_1_3?>"/>
	Unit name or number 
	<input name="k2_1_4" type="text" value="<?= @$info->k2_1_4?>"/>                    
	Role 
	<input name="k2_1_5" type="text" value="<?= @$info->k2_1_5?>"/>
	<br />
	<br />
	Date from(dd/mm/yy ) 
	<input name="k2_2_1" type="text" value="<?= @$info->k2_2_1?>" id="k2_2_1"/>                   
	Date to(dd/mm/yy ) 
	<input name="k2_2_2" type="text" value="<?= @$info->k2_2_2?>" id="k2_2_2"/>
	<br />
	Rank 
	<input name="k2_2_3" type="text" value="<?= @$info->k2_2_3?>"/>
	Unit name or number 
	<input name="k2_2_4" type="text" value="<?= @$info->k2_2_4?>"/>                    
	Role 
	<input name="k2_2_5" type="text" value="<?= @$info->k2_2_5?>"/>
	<br />
	<br />
	Date from(dd/mm/yy ) 
	<input name="k2_3_1" type="text" value="<?= @$info->k2_3_1?>" id="k2_3_1"/>                   
	Date to(dd/mm/yy ) 
	<input name="k2_3_2" type="text" value="<?= @$info->k2_3_2?>" id="k2_3_2"/>
	<br />
	Rank 
	<input name="k2_3_3" type="text" value="<?= @$info->k2_3_3?>"/>
	Unit name or number 
	<input name="k2_3_4" type="text" value="<?= @$info->k2_3_4?>"/>                    
	Role 
	<input name="k2_3_5" type="text" value="<?= @$info->k2_3_5?>"/>
	<br />
	<br />
	Date from(dd/mm/yy ) 
	<input name="k2_4_1" type="text" value="<?= @$info->k2_4_1?>" id="k2_4_1"/>                   
	Date to(dd/mm/yy ) 
	<input name="k2_4_2" type="text" value="<?= @$info->k2_4_2?>" id="k2_4_2"/>
	<br />
	Rank 
	<input name="k2_4_3" type="text" value="<?= @$info->k2_4_3?>"/>
	Unit name or number 
	<input name="k2_4_4" type="text" value="<?= @$info->k2_4_4?>"/>                    
	Role 
	<input name="k2_4_5" type="text" value="<?= @$info->k2_4_5?>"/>
	<br />
	<br />
	Date from(dd/mm/yy ) 
	<input name="k2_5_1" type="text" value="<?= @$info->k2_5_1?>" id="k2_5_1"/>                   
	Date to(dd/mm/yy ) 
	<input name="k2_5_2" type="text" value="<?= @$info->k2_5_2?>" id="k2_5_2"/>
	<br />
	Rank 
	<input name="k2_5_3" type="text" value="<?= @$info->k2_5_3?>"/>
	Unit name or number 
	<input name="k2_5_4" type="text" value="<?= @$info->k2_5_4?>"/>                    
	Role 
	<input name="k2_5_5" type="text" value="<?= @$info->k2_5_5?>"/>
	<br />
	<br />
	Date from(dd/mm/yy ) 
	<input name="k2_6_1" type="text" value="<?= @$info->k2_6_1?>" id="k2_6_1"/>                   
	Date to(dd/mm/yy ) 
	<input name="k2_6_2" type="text" value="<?= @$info->k2_6_2?>" id="k2_6_2"/>
	<br />
	Rank 
	<input name="k2_6_3" type="text" value="<?= @$info->k2_6_3?>"/>
	Unit name or number 
	<input name="k2_6_4" type="text" value="<?= @$info->k2_6_4?>"/>                    
	Role 
	<input name="k2_6_5" type="text" value="<?= @$info->k2_6_5?>"/>
	<br />
	<br />				</td>
               </tr>
               <tr>
                 <td colspan="2">List any military identity numbers you were given. 
                   <input name="k2_7" type="text" value="<?= @$info->k2_7?>" style="width:300px"/></td>
               </tr>
             </table></td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">K3 Are you presently subject to military service obligations in any country?<br />
		     <table width="90%">
               <tr>
                 <td width="8%"><input type="radio" name="is_k3" value="1" <?= (@$info->is_k3==1)?'checked':''?> />
                   Yes </td>
                 <td width="92%">If you are a citizen of a country in which compulsory military service exists, provide details.<br />
                 	<textarea name="k3"><?= @$info->k3?></textarea></td>
               </tr>
               <tr>
                 <td><input type="radio" name="is_k3" value="0" <?= (@$info->is_k3==0)?'checked':''?> />
                   No </td>
                 <td>&nbsp;</td>
               </tr>
             </table></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">K4 Have you been associated with any intelligence agency or group, or law enforcement agency?<br />
		     <table width="90%">
               <tr>
                 <td width="8%"><input type="radio" name="is_k4" value="1" <?= (@$info->is_k4==1)?'checked':''?> />
                   Yes </td>
                 <td width="92%">Describe how you were involved.
                   <br />
                   <textarea name="k4"><?= @$info->k4?></textarea></td>
               </tr>
               <tr>
                 <td><input type="radio" name="is_k4" value="0" <?= (@$info->is_k4==0)?'checked':''?> />
                   No </td>
                 <td>&nbsp;</td>
               </tr>
             </table></td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">K5 Have you been associated with any group or organisation that has used or promoted violence to further their aims?<br />
		     <table width="90%">
               <tr>
                 <td width="8%"><input type="radio" name="is_k5" value="1" <?= (@$info->is_k5==1)?'checked':''?> />
                   Yes </td>
                 <td width="92%">Describe how you were involved.<br />
                   <textarea name="k5" ><?= @$info->k5?></textarea></td>
               </tr>
               <tr>
                 <td><input type="radio" name="is_k5" value="0" <?= (@$info->is_k5==0)?'checked':''?> />
                   No </td>
                 <td>&nbsp;</td>
               </tr>
             </table></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">K6 Have you ever committed or been involved in war crimes, crimes against humanity, and/or human rights abuses?<br />
		     <table width="90%">
               <tr>
                 <td width="8%"><input type="radio" name="is_k6" value="1" <?= (@$info->is_k6==1)?'checked':''?> />
                   Yes </td>
                 <td width="92%">Describe how you were involved.<br />
                   <textarea name="k6" ><?= @$info->k6?></textarea></td>
               </tr>
               <tr>
                 <td><input type="radio" name="is_k6" value="0" <?= (@$info->is_k6==0)?'checked':''?> />
                   No </td>
                 <td>&nbsp;</td>
               </tr>
             </table></td>
		</tr>
		
		<tr class="even">
		   <td colspan="5"><strong>Section L Declaration by applicant</strong></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">All applicants must complete this section.<br />
		     I have provided true and correct answers to the questions in this form.<br />
		     I agree to tell Immigration New Zealand about any changes to my circumstances that occur after making this application.<br />
		     I agree to leave New Zealand before my visa expires. If I remain in New Zealand after my visa has expired, I may be liable for deportation.<br />
		     I agree that if I am not entitled to free health care in New Zealand, I will pay for any health care or medical assistance I may require in New Zealand.<br />
		     I understand that if I have received immigration advice from an immigration adviser and if that immigration adviser is not licensed under the Immigration Advisers Licensing Act 2007 when they should be, Immigration New Zealand will return my application.<br />
		     I understand that Immigration New Zealand may provide information about my entitlement to work to potential employers via the online VisaView system. VisaView is authorised by legislation.<br />
		     I authorise Immigration New Zealand to provide information about my health and my immigration status to any health service agency. I authorise any health service agency to provide information about my health to Immigration New Zealand. I authorise Immigration New Zealand to make any necessary enquiries about information on this form so that they can:<br />
		     • make a decision on this application<br />
		     • answer enquiries about my immigration status once my application has been decided.<br />
		     I authorise any agency that holds information (including personal information) related to those matters to disclose that information to Immigration New Zealand.<br />
		     I authorise Immigration New Zealand to provide information about my immigration status to my past, present or future education provider and to the International Education Appeal Authority.<br />
		     If I am granted a student visa with the condition that I am accompanied by a legal guardian, I agree to live with my legal guardian. I understand that my visa and the visa of my legal guardian may be withdrawn if I do not meet this condition.<br />
		     If I am granted a limited visa, I agree that I will leave New Zealand on or before the expiry date of that visa. If I do not leave New Zealand, I may be immediately deported from New Zealand without the right of appeal.<br />
		     <br />
		     Signature of applicant 
		      
		      Date
		      (DDMMYYYY) </td>
		</tr>
		
		<tr class="even">
		   <td colspan="5"><strong>Section M Immigration adviser’s details</strong></td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">This section must be completed by the applicant’s immigration adviser. If the applicant does not have an immigration adviser, this section does not have to be completed.</td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">M1 Tick the one option that applies to you.<br />
		     &nbsp;<input type="radio" name="is_m1" value="1" <?= (@$info->is_m1==1)?'checked':''?> />
		     I am a licensed immigration adviser under the New Zealand Immigration Advisers Licensing Act 2007. Go to M2<br />
		     &nbsp;<input type="radio" name="is_m1" value="2" <?= (@$info->is_m1==2)?'checked':''?> />		      I am exempt from licensing under the New Zealand Immigration Advisers Licensing Act 2007. Go to M3 .<br />
		     If you are unlicensed when you should be licensed under the Immigration Advisers Licensing Act 2007, Immigration New Zealand will return your client’s application. It is an offence to provide immigration advice without holding a licence, unless you are exempt.</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">M2 Licensed advisers. Provide your licence details.<br />
		     <table width="90%">
               <tr>
                 <td width="14%">Licence type</td>
                 <td width="86%">
                   <input type="radio" name="is_m2" value="1" <?= (@$info->is_m2==1)?'checked':''?> />
                   full                  
                   <input type="radio" name="is_m2" value="2" <?= (@$info->is_m2==2)?'checked':''?> />
                   provisional 
                   <br />
                   <input type="radio" name="is_m2" value="3" <?= (@$info->is_m2==3)?'checked':''?> />
limited. List conditions specified in the register. <br />
                 <textarea name="m2_1"><?= @$info->m2_1?></textarea></td>
               </tr>
               <tr>
                 <td>Licence number</td>
                 <td>20 
                   <input name="m2_2" type="text" value="<?= @$info->m2_2?>"/> Go to Section N: Declaration by person assisting the applicant.</td>
               </tr>
             </table></td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">M3 Exempt from licensing. Tick one box below to show why you are exempt from licensing.<br />
&nbsp;<input type="radio" name="is_m3" value="1" <?= (@$info->is_m3==1)?'checked':''?> />
I provided immigration advice in an informal or family context only, and I did not provide the advice systematically or for a fee.<br />
&nbsp;<input type="radio" name="is_m3" value="2" <?= (@$info->is_m3==2)?'checked':''?> />
I am a New Zealand member of Parliament or member of their staff and I provided immigration advice as part of my employment agreement.<br />
&nbsp;<input type="radio" name="is_m3" value="3" <?= (@$info->is_m3==3)?'checked':''?> />
I am a foreign diplomat or consular staff.<br />
&nbsp;<input type="radio" name="is_m3" value="4" <?= (@$info->is_m3==4)?'checked':''?> />
I am an employee of the New Zealand public service and I provided immigration advice within the scope of my employment agreement.<br />
&nbsp;<input type="radio" name="is_m3" value="5" <?= (@$info->is_m3==5)?'checked':''?> />
I am a lawyer and I hold a current practising certificate as a barrister or as a barrister and solicitor of the High Court of New Zealand.<br />
&nbsp;<input type="radio" name="is_m3" value="6" <?= (@$info->is_m3==6)?'checked':''?> />
I am employed by, or I am working as a volunteer for, a New Zealand community law centre where at least one lawyer is on the employing body of the community law centre or is employed by or working as a volunteer for the community law centre in a supervisory capacity.<br />
&nbsp;<input type="radio" name="is_m3" value="7" <?= (@$info->is_m3==7)?'checked':''?> />
I am employed by, or I am working as a volunteer for, a New Zealand citizens advice bureau.<br />
&nbsp;<input type="radio" name="is_m3" value="8" <?= (@$info->is_m3==8)?'checked':''?> />
I provided immigration advice offshore in relation to applications or potential applications for student visas only.</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5"><strong>Section N Declaration by person assisting the applicant</strong></td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">This section must be completed and signed by the applicant’s immigration adviser, or by any person who has assisted the applicant by providing immigration advice, explaining, translating, or recording information on the form for the applicant. If the applicant does not have an immigration adviser, and no one helped the applicant to fill in this form, this<br />
		     section does not have to be completed.<br />
		     <br />
		     If you are unlicensed when you should be licensed under the Immigration Advisers Licensing Act 2007, Immigration New Zealand will return your client’s application. It is an offence to provide immigration advice without holding a licence.<br />
		     For more information, go to the Immigration Advisers Authority website www.iaa.govt.nz, or email info@iaa.govt.nz or write to them at PO Box 6222, Wellesley Street, Auckland 1141, New Zealand.</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">Name and address of person assisting applicant. 
		     <input type="radio" name="is_n1" value="1" <?= (@$info->is_n1==1)?'checked':''?> />		     
		      Same as address given at B3 , or 
		      <input type="radio" name="is_n1" value="2" <?= (@$info->is_n1==2)?'checked':''?> />
		      as below.<br />
		      Family/last name 
		      <input name="n2" type="text" value="<?= @$info->n2?>"/>		      
		       Given/first name(s) 
	          <input name="n3" type="text" value="<?= @$info->n3?>"/><br />
	          Company name (if applicable) and address 
	          <input name="n4" type="text" value="<?= @$info->n4?>" style="width:500px"/>
	          <br />
	          Telephone (daytime) 
	          <input name="n5" type="text" value="<?= @$info->n5?>"/>
	           Telephone (evening) 
              <input name="n6" type="text" value="<?= @$info->n6?>"/>              
               <br />
               Fax 
              <input name="n7" type="text" value="<?= @$info->n7?>"/>              
               Email 
              <input name="n8" type="text" value="<?= @$info->n8?>" id="n8"/></td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">I understand that after the applicant has signed this form it is an offence for me to change or add further information, change any documents attached to the form, or attach any further documents to the form. However, if changes are needed, the person making the changes must state on the form what information or documents have been changed and<br />
		     give reasons for the changes.<br />
		     I note that the maximum penalty for this offence is a fine of up to NZ$100,000 and/or a term of imprisonment of up to seven years.<br />
		     I certify that the applicant asked me to help them complete this form and any additional forms. I certify that the applicant agreed that the information provided was correct before signing the declaration.</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">&nbsp;<input type="radio" name="is_n9" value="1" <?= (@$info->is_n9==1)?'checked':''?> />
		     I have assisted the applicant as an interpreter/translator<br />
		     &nbsp;<input type="radio" name="is_n9" value="2" <?= (@$info->is_n9==2)?'checked':''?> />
		     I have assisted the applicant with recording information on the form<br />
		     &nbsp;<input type="radio" name="is_n9" value="3" <?= (@$info->is_n9==3)?'checked':''?> />
		     I have assisted the applicant in another way. Specify 
		     <input name="n10" type="text" value="<?= @$info->n10?>" style="width:300px"/>
		     <br />
		     &nbsp;<input type="radio" name="is_n9" value="4" <?= (@$info->is_n9==4)?'checked':''?> />
		     I have provided immigration advice (as defined in the Immigration Advisers Licensing Act 2007) and my details in Section M: Immigration adviser’s details are correct.</td>
		</tr>
		
		<tr class="even">
		   <td colspan="5">&nbsp;</td>
		</tr>
		
		<tr class="odd">
		   <td colspan="5">&nbsp;</td>
		</tr>
    </tbody>
	</table>
<!-- table end -->
</form>

			</div>
		</div>
		
		<?=$this->load->view('include_sidebar',array('id'=>$id,'forms'=>$forms))?>
	</div>

<script type="text/javascript">
$().ready(function() {
  $("#form").validate({
    rules: {
		surname:"required",
		firstname:"required",
		title:"required",
		sex:"required",
		birth:"required",
		travel_document_num:"required",
		travel_document_valid_date:"required",
		travel_document_country:"required",
		citizenship:"required",
		marital_status:"required"
    }
  });
  
	$.datepicker.setDefaults(
		{
		dateFormat: 'dd/mm/yy',
		changeMonth: true,
		changeYear: true,
		showOn: "both",
		buttonImage: "images/calendar.gif",
		buttonImageOnly: true
		}
	);
	
	$("#birth").datepicker();
	$("#travel_document_valid_date").datepicker();
	$("#emp1_from").datepicker();
	$("#emp1_to").datepicker();
	$("#emp2_from").datepicker();
	$("#emp2_to").datepicker();
	$("#emp3_from").datepicker();
	$("#emp3_to").datepicker();
	$("#emp4_from").datepicker();
	$("#emp4_to").datepicker();
	$("#emp5_from").datepicker();
	$("#emp5_to").datepicker();
	$("#c4").datepicker();
	$("#c9_2").datepicker();
	$("#d5_2").datepicker();
	$("#e1_1").datepicker();
	$("#e1_2").datepicker();
	$("#f1").datepicker();
	$("#f2").datepicker();
	$("#f3").datepicker();
	$("#h4").datepicker();
	$("#h6_3").datepicker();
	$("#i1_1_2").datepicker();
	$("#i1_2_2").datepicker();
	$("#k2_1_1").datepicker();
	$("#k2_1_2").datepicker();
	$("#k2_2_1").datepicker();
	$("#k2_2_2").datepicker();
	$("#k2_3_1").datepicker();
	$("#k2_3_2").datepicker();
	$("#k2_4_1").datepicker();
	$("#k2_4_2").datepicker();
	$("#k2_5_1").datepicker();
	$("#k2_5_2").datepicker();
	$("#k2_6_1").datepicker();
	$("#k2_6_2").datepicker();
	
	$("#email").autoMail();
	$("#nz_email").autoMail();
	$("#postal_email").autoMail();
	$("#n8").autoMail();

	$("#printInfo").click(function(o) {
		var prints = [
			{rel_id: <?=$cateid?>, rec_id: <?=$id?>}
		]  ;
		
		var jdata = JSON.stringify(prints);
		//alert(jdata);
		$.post("<?=site_url('proxy/does/'.str_replace('==','',base64_encode('http://'.$_SERVER['SERVER_NAME'].':9090/javaprduct/servlet/test')))?>",{clients:jdata},function(msg){alert(msg)});
	});
	
	$("#printInfo").ajaxError(function(event,request, settings){
		//$(this).append("<li>出错页面:" + settings.url + "</li>");
		alert("无法访问"+ settings.url );
	}); 
 
});
</script>

<?=$this->load->view('include_footer',null)?>